Our growing ability to prolong life and our shrinking ability to pay for it

There have been scores of recent articles about Congresswoman-elect Kathy Hochul’s upset win in New York’s 26th Congressional District special election.  They all seem to share a thread of incredulity, followed either by chortling or spin depending on the source.  These stories also share the sense that her victory was truly an underdog performance destined to become legend.

According to The New York Times, “Two months ago, the Democrat … was considered an all-but-certain loser against the Republican.”  Imagine that Republican’s surprise at having to give the congratulatory call on election night.

The pundits are laying blame at the feet of Republican candidate Jane Corwin for backing Wisconsin Congressman Ryan’s proposal to reduce the federal deficit in part by changing Medicare to a voucher system.  The Times, again: “Ms. Hochul seized on the Republican’s embrace of the proposal … to overhaul Medicare, and she never let up.”  Both candidates’relative energy and focus are also being credited or blamed for the result, but all sides agree that the singular focus on Medicare carried the day.

This election result is being touted as a modern-day example of the “Third Rail” of entitlements – touch it and get burned.  A quick Google search turns up at least a few of Indiana’s own Representatives who may be eligible to have the same sort of uncomfortable questions about “abolishing Medicare” asked by future contenders.  I will leave them unnamed in service of civility, but I don’t doubt some home office staff for each is working on a damage-control plan.  They are unlikely to feel too comfortable, since NY-26 is a real ‘red’ district, unused to electing Democrats to Congress.

In broader terms, I think this election result highlights two opposing and mutually-exclusive feelings held by much of our society today.  The first is “You’d better not raise my taxes or I’ll fire you!”  Of course, the second is “You’d better not take away any of my benefits or I’ll fire you!”

Unfortunately logic, cold and ugly as it usually is, says that only one of these demands can be met at any one time. This leaves the politicians scrambling to explain to an angry and often irrational populace that hard choices must be made.  As someone watching from the inside as our medical system crumbles, I can say with great assurance that what we are presently doing cannot continue.  It is crystal clear that something, or many things, must change.  What will change is truly up to us but the fact that change is coming and must come is undeniable.

Only a great fool would expect our Chinese bankers to continue to extend ever-more-tenuous lines of credit so that we can live as we please and ignore economic realities.  Thankfully, not a one of us is a great fool.  This leaves me in a quandary to explain the gridlock Congress seems to love regarding the topic of healthcare reconstruction – reform seems too limited a word.

Simply combine our growing ability to improve and prolong life with our shrinking ability to pay for it and you have a recipe for widespread disappointment or worse. The only solution is one that we had best come to as quickly as possible.  We must decide whether we are going to have our cake or eat it, because we certainly can’t and never will be able to do both.

Eric Marcotte is a family physician who blogs at doctorfoodtruth.

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